Disparities in infant mortality more to do with racism than with race

Aug 1 2007

The cause of low birth weights among African-American women has more to do with racism than with race, according to a report by an associate professor of pediatrics at the University of Illinois at Chicago.

In a report published in the July issue of the American Journal of Public Health, Richard David says the quest for a "pre-term birth gene" that is now underway will be of no value in explaining low birth weights.

David is the report's lead writer and co-author with James Collins Jr., professor of pediatrics at Northwestern University. David is affiliated with John H. Stroger Jr. Hospital and Collins with Children's Memorial Hospital.

They compared birth weights of three groups of women: African American, whites and Africans who had moved to Illinois. Most African-American women are of 70 to 75 percent African descent.

"If there were such a thing as a (pre-term birth) gene, you would expect the African women to have the lowest birth weights," David said. "But the African and white women were virtually identical," with significantly higher birth weights than the African-American women, he said.

The researchers did a similar analysis of births to black Caribbean women immigrants to the United States and found they gave birth to infants hundreds of grams heavier than the babies of U.S.-born black women.

For black women, "something about growing up in America seems to be bad for your baby's birth weight," David said.

Another argument against a genetic cause is that children of American black women rate higher for all the major causes of death in the child's first year.

"Genetic diseases pop up at random in different (racial) populations," David noted. "But one group is taking all the hits. If this were a genetic problem it wouldn't fit that pattern."

Moreover, birth weights are not static but change in every population and from one generation to the next. Genetic shifts, however, "take place over thousands or tens of thousands of years," he said.

One reason African-American mothers have babies who weigh less at birth is that they are at greater risk for such conditions as high blood pressure and preeclampsia.

Also, minority women are subject to stress caused by perceived racial discrimination, the researchers said.

David and Collins spoke with black women who had babies with normal weights at birth, comparing them with black women whose babies' birth weight was very low -- under three pounds.

They asked the mothers if they had ever been treated unfairly because of their race when looking for a job, in an educational setting or in other situations.

Those who felt discriminated against had a twofold increase in low birth weights. And for those who experienced discrimination in three "domains," the increase was nearly threefold.

In David and Collins' study of black women who gave birth in two Chicago hospitals, 16 percent said their partner was in jail during the pregnancy.

"We interpreted this finding as another indicator of stress, but one caused by institutional rather than interpersonal racial discrimination," David said.